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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy, safety and mechanisms of penicillin desensitization were studied in 24 adults and two children with serious infections that required therapy with a beta-lactam drug. Indications for desensitization included debilitating as well as life-endangering infections. Increasing oral doses of phenoxymethyl penicillin were administered at 15-minute intervals to a cumulative dose of 1.3 million units. Parenteral therapy with the beta-lactam drug of choice was instituted at that point. Immunologic complications of desensitization or therapy, ranging from pruritus to serum sickness, occurred in 12 patients. The appearance of gradually worsening wheezing led to abandonment of the procedure in one subject with cystic fibrosis and severe pulmonary disease. The remaining 25 patients were successfully desensitized and received full-dose parenteral therapy. Chronic desensitization was maintained in seven individuals with twice daily oral penicillins for 3 weeks to more than 2 years. No allergic complications of chronic desensitization or recurrent full-dose parenteral therapy were detected. Skin test reactions to one or all penicillin determinants became negative in 11 of 15 patients retested after acute desensitization. Two desensitized patients became skin test negative, remained skin test negative after cessation of desensitization, and tolerated subsequent beta-lactam therapy without allergic reactions or resensitization. The results of this study provide new evidence that acute and chronic penicillin desensitization is useful and an acceptably safe approach and suggest that antigen-specific mast cell desensitization contributes to the protection against anaphylaxis.
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PMID:Acute and chronic desensitization of penicillin-allergic patients using oral penicillin. 381 32

During the twelve-year period from January 1, 1970, through December 31, 1981, 4,282 patients with the diagnosis of herniated nucleus pulposus were treated by intradiscal injection of chymopapain under local anesthesia. Fifteen (0.35 per cent) of these patients sustained an anaphylactic reaction as defined by us. Twelve patients had subjective early warning signs before their blood pressure decreased, including a total-body burning or tingling sensation (five patients), a general feeling of ill health (four patients), and diffuse pruritus (three patients). Profound hypotension without subjective warning symptoms was the first indication of anaphylaxis in three patients. In all patients, hypotension requiring vigorous treatment was the life-threatening clinical manifestation of anaphylaxis, but respiratory distress severe enough to require endotracheal intubation did not occur. There were no deaths or known sequelae. Ten of the fifteen patients were women. Review of the medical histories of the fifteen patients and follow-up telephone interviews did not identify any other pre-disposing factor for the anaphylaxis. Twelve of the fifteen patients obtained complete relief of the symptoms of disc herniation. The advantage of the use of local rather than general anesthesia for chymopapain injection is that the patient remains responsive and can give an early warning of the subjective symptoms of anaphylaxis if they appear. This potential for early diagnosis allows early and aggressive treatment with intravenous fluids, epinephrine, steroids, and antihistamines, which can be effective in preventing death or permanent sequelae. In our experience, general anesthesia and routine endotracheal intubation are not necessary for intradiscal injection of chymopapain.
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PMID:Anaphylactic reactions following the intradiscal injection of chymopapain under local anesthesia. 636 Oct 34

Exercise-related anaphylaxis is a novel form of physical allergy that is being recognized with increasing frequency in a society with a growing commitment to health through planned exercise. The clinical manifestations progress from pruritus, erythema, and urticaria to some combination of cutaneous angioedema, gastrointestinal and laryngeal symptoms and signs of angioedema, and vascular collapse. The finding of an elevated serum histamine level during experimentally-induced attenuated attacks indicates mast cell participation, as in a physical allergy, and the signs and symptoms are characteristic of a classic anaphylactic reaction to a foreign substance in an allergic human.
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PMID:Exercise-induced anaphylaxis. 671 33

Seven individuals with exercise-induced anaphylaxis under natural circumstances, characterized by the appearance of pruritic cutaneous erythema and urticaria and associated vascular collapse and/or upper respiratory tract symptoms and signs of angioedema, were subjected to a controlled period of exercise in a laboratory. Experimental challenge consisted of running in an occlusive suit on a treadmill of moving grade with maintenance or acceleration of speed for 5 to 17 min. Cutaneous pruritus and erythema without urticaria developed in four of the subjects and progressed to angioedema in two of them; the other three subjects were unaffected. Repeat challenge of three of the abnormal responders elicited a clinical response similar to that of the previous exercise challenge. In those subjects with a clinical response to exercise challenge, mean change from baseline levels of histamine to peak levels was 7.0 +/- 3.0 ng/ml (mean +/- SEM), whereas in the group without clinical symptoms the mean change from baseline was an increase of 0.6 +/- 1.6 ng/ml (mean +/- SEM). The abnormal elevations in serum histamine during the seven exercise-induced symptomatic episodes returned to normal in about 20 min while clinical signs were also subsiding. There were no changes in pulmonary function. Exercise-induced anaphylaxis is clinically separable from cholinergic urticaria and represents a distinct form of physical allergy.
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PMID:Exercise-induced anaphylaxis: a distinct form of physical allergy. 682 91

Cisplatin, 50-150 mg in a maximum concentration of 1 mg/ml, was administered intravesically each week to 24 patients with multiple, recurrent carcinoma in situ and/or bladder tumors confined to the mucosa and lamina propria. All patients had a history of multiple transurethral resections and four had received prior chemotherapy. Response was evaluated by urinary cytology, cystoscopy, and biopsy. In a total of 237 weekly doses, toxicities included mild dysuria, pruritus, rash and in one patient, acute anaphylaxis. Only three (13%) patients were classified as achieving complete remission. Cisplatin, in the dose and schedule employed, is ineffective in controlling superficial bladder cancer.
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PMID:Intravesical cisplatin for superficial bladder tumors. 720 43

Sixteen patients were seen because of possibly life-threatening exercise-associated symptoms similar to anaphylactic reactions. Asthma attacks, cholinergic urticaria and angioedema, and cardiac arrythmias are recognized as exertion-related phenomena in predisposed patients but are distinct from the syndrome described here. A syndrome characterized by the exertion-related onset of cutaneous pruritus and warmth, the development of generalized urticaria, and the appearance of such additional manifestations as collapse in 12 patients, gastrointestinal tract symptoms in five patients, and upper respiratory distress in 10 patients has been designated exercise-induced anaphylaxis, because of the striking similarity of this symptom complex to the anaphylactic syndrome elicited by ingestion or injection of a foreign antigenic substance. There is a family history of atopic desease for 11 patients and cold urticaria for two others and a personal history of atopy in six. The size of the wheals, the failure to develop an attack with a warm bath or shower or a fever, and the prominence of syncope rule against the diagnosis of conventional cholinergic urticaria. There is no history or evidence of an encounter with an environmental source of antigen during the exercise period.
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PMID:Exercise-induced anaphylaxis. 740 Apr 73

This communication describes the first known report of sulindac-induced anaphylaxis. A 17-year-old patient who ingested a single tablet of sulindac developed pruritus, hives, and dyspnea. Blood pressure was not detectable. The patient was treated with epinephrine, a corticosteroid, and an antihistamine. Recovery was complete. The ability of this class of drugs to produce dangerous reactions is discussed.
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PMID:Sulindac-induced anaphylaxis. 746 57

A 20-year-old female was brought to our emergency unit with generalized erythema and discomfort induced by running after having eaten wheat bread. The laboratory examinations, including eosinophils, total IgE, RAST score to wheat, heat challenge test and methacholine inhalation test were within normal limits. No anaphylactoid responses occurred after provocation tests of wheat bread intake or exercise alone. However, on provocation exercise test after eating pancakes, she developed hypotension, generalized itching and urticaria associated with an elevation of plasma histamine levels. These findings suggested wheat-dependent exercise-induced anaphylaxis. This was completely prevented by daily administration of terfenadine 120 mg p.o. without side effects such as fatigue or drowsiness.
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PMID:Successful prophylaxis of wheat-dependent exercise-induced anaphylaxis with terfenadine. 749 78

The athlete who suffers from atopic diseases such as seasonal allergic rhinitis has an arsenal of antihistamines from which to choose for relief of symptoms. The decision to select a particular medication involves consideration of its efficacy and its side effects. Many of the standard antihistamines have sedative side effects which render them undesirable for use by athletes during competition. For example, a survey of studies suggests that some of these medications may compromise the performance of psychomotor skills important to the athlete (e.g. reaction time and visual discrimination). The newer, nonsedating antihistamines are equal to the standard agents in efficacy and comparable with placebo in central nervous system effects. Thus, psychomotor performance is not adversely affected by the newer antihistamines. Despite their widespread use, the effects of treatment with antihistamines on exercise performance (e.g. metabolic responses and time to exhaustion) have scarcely been addressed. The few studies available indicate that single oral administrations of antihistamines neither compromise nor enhance exercise performance or tolerance in asymptomatic individuals. Yet the research conducted has not examined the effects of antihistamine ingestion on exercise performance in symptomatic individuals. Whether treatment with an antihistamine would improve exercise performance relative to nontreatment in symptomatic, atopic athletes remains to be determined. Whereas there is a dearth of information on the effects of antihistamine medications on exercise performance, there is growing evidence that pretreatment with antihistamines may prevent or attenuate some exercise-induced histamine-mediated disorders such as urticaria, pruritus, anaphylaxis and gastrointestinal bleeding. A survey of studies suggests that prophylactic treatment with antihistamines may increase tolerance to exercise in individuals susceptible to these disorders.
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PMID:Effects of antihistamine medications on exercise performance. Implications for sportspeople. 768 Aug 15

Cutaneous mastocytosis usually includes objective skin signs such as pigmented maculopapulae or skin infiltration. We report an unusual case of cutaneous mastocytosis without systemic involvement in a 9-month old infant. Clinical expression was entirely functional (pruritus, urticaria) with no permanent lesions. There were 22 times more mastocytes found in the skin biopsy than in similar biopsies obtained in healthy control subjects of the same age, which corresponds to the counts found in cutaneous mastocytosis. Diffuse cutaneous mastocytosis with no permanent lesions is an exceptional form of mastocytosis (3 cases reported in the literature). The long-term outcome is unknown. This syndrome should be distinguished from idiopathic anaphylaxis by quantification of the dermal mastocytes.
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PMID:[Diffuse cutaneous mastocytosis without permanent lesion]. 775 14


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